Eric Dishman is used to thinking about how technology can transform the world of health care. As an Intel Fellow and general manager of the company’s Health Strategy & Solutions Group, his job is all about finding innovative new approaches to healthcare. Eric Dishman: Take health care off the mainframe And he’s no stranger to talking about them. At TEDMED 2009, in the talk featured to the left, Dishman asked us to “Take health care off the mainframe,” boldly comparing the current American health care system to mainframe computers circa 1959.

But just two weeks ago, at TED@Intel, Dishman tells the much more personal story of his battle with kidney disease.

To say that his battle is with disease isn’t the full story. Instead, as he describes in this second talk, his fight is not only with faulty kidneys, Eric Dishman: Health care should be a team sportbut also with a flawed healthcare system.

Two decades ago, when he was a college student, Dishman had several fainting spells. This kicked off months of testing by six different doctors, in what he describes as a “clash of medical titans.” Dishman was told he would not live longer than two or three years.

The doctors were wrong — but not because they weren’t good doctors. Instead, they were stuck in an old-fashioned system that lacked technologically advanced tools and a culture of communication.

With smartphones and tablets becoming increasingly ubiquitous, and social networks connecting us more and more, Dishman sees three major steps to achieving better, individually-tailored healthcare that takes pressure off of brick-and-mortar hospitals and clinics, and empowers a patient to be the captain of a team working toward their well-being: Care anywhere, care networking, and care customization. To hear what each means, watch this talk.

On the stage, Dishman demonstrates MobiSante’s smartphone-based ultrasound imaging system, called MobiUS, which he used to scan his newly donated kidney. A doctor hours away at Legacy Good Samaritan Hospital in Oregon examined the kidney live over the Internet, dispelling worry over a few dark spots and noting they’d double check them at Dishman’s next scheduled appointment.

Here is a round up of other disruptive products and projects that could hugely impact the way we think about our health care. Have more to add? Put them in the comments.

Health tests on your smartphone
MobiSante’s affordable, portable ultrasound isn’t the only medical device to take advantage of mobile networks and the power of smartphones. Some other examples:

• Lifelens’s app can detect malaria in a blood sample and allow a diagnosis from across the world.
• University of Oxford’s stethoscope kit is a low-cost way for patients to take recordings of their hearts to send it to their doctors for analysis.
• MIT Media Lab’s NETRA is a cheap eye test that connects to a smartphone. Here, a look a TED Blog Q&A with one of its creators.
• Withings’ blood pressure monitor lets users take their own blood pressure with an iPhone, iPad, or iPod touch.

The doctor isn’t in… but that’s okay
InTouch Health’s RP-VITA Remote Presence Robot is the first-ever that will connect doctors to patients across the world.Daniel Kraft: Medicine's future? There's an app for that Doctors can do rounds in a hospital across the country or the world, controlling Jetson-like robots that show their faces on a screen. Through the robots, the doctors can visit with and diagnose patients from afar.

Another less-futuristic option: as Daniel Kraft, the chair of the FutureMed program at Singularity University, mentioned in the TED Talk, “Medicine’s future? There’s an app for that,” the website AmericanWell.com can connect you to physicians and specialists in your state who do appointments over secure chat, Skype or the telephone.

Health care at your local drugstore
While it isn’t tech-heavy, the move towards what this recent article from The Economist calls “retail clinics” is taking some health services out of hospitals and doctor’s offices and into malls and popular pharmacy chains. The article details how CVS and Walgreens are bringing basic care clinics to many stores – 640 and 372 of them respectively.

Medical devices that can leave the hospital
The U.S. Department of Health and Human Services put out a recent request for information seeking new approaches for smart medical hardware that can remain on even during power outages in natural disasters. The goal is to to protect hospital patients on life-saving medical devices — including ventilators or IV pumps — by keeping the machines on and mobile if there is need for evacuation.

Are you interested in where health care is going? Watch the TED Playlist, the Future of Medicine, below.

A vast gulf in care

Vikram Patel asks us to imagine two men who live in the same town. They have the same education, the same jobs, and everything else the same. Both present at a hospital with chest pains — but one is treated and one is not. Why? The second one has a mental illness.

That is one of the biggest reasons people with mental illness live shorter lives. (In some places, the gap in life expectancy is 20 years.) Of course, there are more direct ways that mental illness can kill you, such as suicide — one of the leading causes of death, even in the poorest countries in the world. The World Health Organization estimates that 400 million to 500 million people are affected by mental illness. The number sounds surprising, he says. “But imagine the diversity of mental health problems… Everyone knows someone with such a condition.”

Those are staggering numbers, but what’s truly worrying, Patel says, is that “the vast majority of these individuals do not receive the care that can vastly improve their lives.” Even in developed countries as many as 50 percent of people don’t receive appropriate care. In developing countries, it’s close to 90 percent.

If you talk to someone with mental illness, or their caregiver, you will find stories of extraordinary pain — and learn that people with mental illness often experience the worst abuses. And some of the worst abuse happens in the place created to cure them, the mental hospital.

Imagining a bridge

There is a gulf, says Patel, between the knowledge we have of how to improve lives, and what we do with it. This is the gulf he is trying to bridge. He trained as a psychiatrist in Britain, surrounded by talented, compassionate, skilled and highly trained colleagues.

Then he went to Zimbabwe.

There he found just about a dozen psychiatrists in the whole country. Most of those serving the needs of those in the city, leaving almost no one for the rural population. In India, the situation was not much better. India should have 150,000 psychiatrists to have the same proportion as the UK, but the number is actually about 3000. It was simply not feasible or affordable to develop quality care. He had to think about different resources to deliver the care.

Then he found some simple books on how to train laypeople to deliver health care — such as, “Where There Is No Doctor” and “People’s Health in People’s Hands.” Those books talk about ways to train people to do all kinds of complex medical tasks. If you could get people to do that, why not mental health care?

Beginning the construction

He reports that there have been some experiments in doing exactly that. He has three examples, all about depression, the most common of mental illnesses.

One trained locals to deliver psychotherapy, leading to 90 percent recovery, compared to about 45 percent in surrounding areas. A second group did a randomized trial of cognitive behavioral therapy, producing 75 percent recovery, compared to about 45 percent. In his own trial they trained ley counselors to deliver psychosocial therapies, and got 70 percent recovery, compared to around 50 percent.

He has an acronym to summarize what’s needed to train these people: SUNDAR.

• Simplify the message
• UNpack the treatment
• Deliver it where people are
• Affordable and available human resources
• Reallocation of specialists to train and supervise

The need for a very large bridge

In the developed world, mental health costs are spiraling out of control, and “a huge chunk of those costs are human resources.” What’s spectacular about SUNDAR, Patel says, is that it is fundamentally empowering. It lets people care for others, and become more invested in their own care as well.

“In order for us to achieve health for all,” says Patel, “we will have to involve all in that particular journey. And in the case of mental health, we will need to involve those affected by mental illness and their caregivers.” As part of that, The Movement for Global Mental Health established as a platform where doctors and those with mental illness can stand together.

In closing, he asks us, “If you have a moment for peace and quiet, spare a moment for the person you know with mental illness, and dare to care for them.”

Photos: James Duncan Davidson